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Ventilator Associated Pneumonia (VAP) is a serious complication in critically ill patients, and oral hygiene care may effectively reduce its incidence. The prevention of VAP is much more effective through the implementation of several interventions that together give rise to a potentially synergistic effect. From January 2018, according to the latest guidelines and the internal department protocol at the Paediatric Intensive Care Unit of A. Gemelli University Hospital, the measures for the management of the VAP have been implemented. Chlorhexidine 0.12% has been used, within the oral hygiene procedures established by the protocol, to evaluate its microbiological and clinical effectiveness on the development of ventilator-associated pneumonia in paediatric patients admitted to intensive care undergoing invasive mechanical ventilation. The main purpose of the present study was to verify the effectiveness of the prevention protocol, during its implementation, in reducing the incidence of pneumonia associated with invasive mechanical ventilation. The survey also aimed to evaluate the predictive power of the culture of the pharyngeal swabs, routinely performed according to the scientific evidence, in identifying the colonization of the trachea, in the patients admitted to our intensive care unit and subjected to mechanical ventilation for at least 48 hours. Finally, the research has evaluated the conditions of the stomatognathic apparatus and of all the tissues and organs associated with it in the patients who use ventilators.

Ventilator Associated Pneumonia (VAP) is a serious complication in critically ill patients, and oral hygiene care may effectively reduce its incidence. The prevention of VAP is much more effective through the implementation of several interventions that together give rise to a potentially synergistic effect. From January 2018, according to the latest guidelines and the internal department protocol at the Paediatric Intensive Care Unit of A. Gemelli University Hospital, the measures for the management of the VAP have been implemented. Chlorhexidine 0.12% has been used, within the oral hygiene procedures established by the protocol, to evaluate its microbiological and clinical effectiveness on the development of ventilator-associated pneumonia in paediatric patients admitted to intensive care undergoing invasive mechanical ventilation. The main purpose of the present study was to verify the effectiveness of the prevention protocol, during its implementation, in reducing the incidence of pneumonia associated with invasive mechanical ventilation. The survey also aimed to evaluate the predictive power of the culture of the pharyngeal swabs, routinely performed according to the scientific evidence, in identifying the colonization of the trachea, in the patients admitted to our intensive care unit and subjected to mechanical ventilation for at least 48 hours. Finally, the research has evaluated the conditions of the stomatognathic apparatus and of all the tissues and organs associated with it in the patients who use ventilators.

OBJECTIVE: alcohol abuse represents a risk factor for oral diseases, in particular, oral cancer. Periodontal disease has been showed to be involved in the pathophysiology of cardiovascular and metabolic diseases, such as atherosclerosis and liver steatosis. The role of chronic alcohol consumption on periodontitis is still controversial. The aim of the study was to evaluate the effect of chronic alcohol abuse on oral health. PATIENTS AND METHODS: Twenty-three alcohol use disorders (AUD) patients and twenty-three healthy social drinkers underwent an oral examination by trained oral clinicians in order to evaluate oral and dental health. A questionnaire assessing oral hygiene was administered together with the evaluation of DMFT (decayed, missing, filled teeth), SLI (Silness-Loë plaque index) and CPI (community periodontal index of treatment needs) scores. RESULTS: Alcoholic patients showed significantly lower oral hygiene scores compared to controls. Alcoholic patients showed significantly poorer scores at DMFT, SLI and CPI tests. Moreover, among alcoholics, smokers showed a significantly poorer oral health than non-smokers. CONCLUSIONS: Chronic alcohol abuse increases the risk of dental and periodontal diseases. Smoking represents a significant co-factor. The practice of basic oral hygiene and the access to professional dental care should be encouraged among AUD patients in order to reduce oral diseases.

Different ceramics have been proposed as materials for medical devices. Alumina, zirconium oxide and zirconia toughened alumina are the most studied ceramic materials for biomedical applications. These materials were proposed firstly for orthopaedic prostheses and successively for other purpose such as dental restorations. Alumina showed atoxicity and is well tolerated by bone and soft tissue. Solid specimens showed to be well tolerated by fibroblasts and osteocites. Also inflammatory reaction of alumina, compared with titanium appears lower. Alumina biocompatibility resulted to be comparable to other dental ceramic. Zirconia biocompatibility was studied in vivo and in vitro. In vivo studies were the first to be performed since 1970. Bone and muscle reaction after insertion of a zirconia sample was evaluated. No adverse response was evidenced in these studies. In vitro studies focused on different topics: tissue reaction, mutagenic and carcinogenic power, cell behaviour. Tissue reaction was influenced by the specimen, but in general bulk samples didn't result to be citotoxic. Zirconia didn't show ability to generate mutation or degeneration on cell cultures. Moreover fibroblast showed great ability to grow on zirconia surface. Moreover both zirconia and alumina showed less proinflammatory properties if compared with other biocompatible specimens such as titanium and high density polyethylene. © 2012 by Nova Science Publishers, Inc. All Rights Reserved.

Different ceramics have been proposed as materials for medical devices. Alumina, zirconium oxide and zirconia toughened alumina are the most studied ceramic materials for biomedical applications. These materials were proposed firstly for orthopaedic prostheses and successively for other purpose such as dental restorations. Alumina showed atoxicity and is well tolerated by bone and soft tissue. Solid specimens showed to be well tolerated by fibroblasts and osteocites. Also inflammatory reaction of alumina, compared with titanium appears lower. Alumina biocompatibility resulted to be comparable to other dental ceramic. Zirconia biocompatibility was studied in vivo and in vitro. In vivo studies were the first to be performed since 1970. Bone and muscle reaction after insertion of a zirconia sample was evaluated. No adverse response was evidenced in these studies. In vitro studies focused on different topics: tissue reaction, mutagenic and carcinogenic power, cell behaviour. Tissue reaction was influenced by the specimen, but in general bulk samples didn't result to be citotoxic. Zirconia didn't show ability to generate mutation or degeneration on cell cultures. Moreover fibroblast showed great ability to grow on zirconia surface. Moreover both zirconia and alumina showed less proinflammatory properties if compared with other biocompatible specimens such as titanium and high density polyethylene. Recently the development of a new class of ceramics Zirconia Toughened Alumina (ZTA), and more recently Zirconia Plateled Toughened Alumina (ZPTA) combining the mechanical properties of Alumina and Zirconia has improved the use of these ceramics in biomedical applications (especially in orthopaedic surgery). In vitro tests demonstrated the absence of citotoxicity and mutagenic and carcinogenic power of these materials when cocultured with cells. In vivo tests of bulk materials showed the absence of local and systemic toxicity after implantation into bone. there were no statisti

Ceramic materials are made of an inorganic non-metallic oxide. Usually ceramics are divided into two groups: silicon ceramics and aluminous ceramics. Ceramics are also divided into crystalline and non-crystalline depending on inner molecular organization. Depending on their in vivo behaviour, ceramics are classified as bioresorbable, bioreactive or bioinert. Alumina and zirconia are bioinert ceramics; their low reactivity togheter with their good mechanical features (low wear and high stability) led to use them in many biomedical restorative devices. Their most popular application is in arthroprosthetic joints where they have proven to be very effective, that make their use suitable especially in younger, more active patients. Also dental use of these materials was proposed to achieve aesthetic and reliability of dental restorations.